{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T06:35:01Z","timestamp":1793082901375,"version":"4.5.0"},"reference-count":49,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T00:00:00Z","timestamp":1793059200000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004807","name":"DFG","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004807","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001659","name":"German Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"name":"NADPH","id":[{"id":"https:\/\/ror.org\/01wtcdw56","id-type":"ROR","asserted-by":"crossref"}]},{"DOI":"10.13039\/100017578","name":"Stiftung Mainzer Herz","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100017578","id-type":"DOI","asserted-by":"publisher"}]},{"name":"EXPOHEALTH"},{"name":"Science Initiative of the State of Rhineland-Palatinate"},{"name":"MARKOPOLO"},{"DOI":"10.13039\/501100000780","name":"European Union","doi-asserted-by":"publisher","award":["No.\u202f101156161"],"award-info":[{"award-number":["No.\u202f101156161"]}],"id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Swiss State Secretariat for Education"},{"name":"Research and Innovation","id":[{"id":"https:\/\/ror.org\/001aqnf71","id-type":"ROR","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001468","name":"SERI","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001468","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Scientists of the German Center for Cardiovascular Research","id":[{"id":"https:\/\/ror.org\/031t5w623","id-type":"ROR","asserted-by":"crossref"}]},{"DOI":"10.13039\/100010447","name":"DZHK","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010447","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Partner Site Rhine-Main"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Heated tobacco products (HTPs) are increasingly promoted as \u2018reduced-harm\u2019 alternatives to combustible cigarettes, despite delivering pharmacologically active nicotine and complex aerosols. Independent human data on their acute cardiovascular effects remain limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>In this investigator-initiated, within-subject pre\u2013post study, healthy adult smokers were supervised in their exposure to two consecutive HTP sticks (IQOS). Endothelial function was assessed by brachial artery flow-mediated dilation (FMD), along with haemodynamic parameters, venous blood gas and metabolic markers, and oxidative DNA damage measured by the comet assay. Acute HTP exposure resulted in a significant reduction in FMD, indicating rapid endothelial dysfunction. This was accompanied by an increase in systolic blood pressure, reductions in venous oxygen tension and saturation, and an increase in venous carbon dioxide, consistent with impaired tissue oxygenation. Methaemoglobin levels increased, reflecting oxidative modification of haemoglobin, while metabolic alterations in glucose and lactate suggested nicotine-mediated sympathetic and metabolic stress. Importantly, short-term HTP use induced significant oxidative DNA damage in peripheral blood cells. These effects occurred after a single, real-world exposure in otherwise healthy smokers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Together, these findings demonstrate that HTPs are not biologically inert and that acute exposure is sufficient to trigger vascular dysfunction, systemic metabolic disturbance, and genotoxic stress. The results challenge claims of cardiovascular harm reduction and underscore that all nicotine-containing products remain relevant targets for cardiovascular prevention and regulation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurjpc\/zwag524","type":"journal-article","created":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T06:01:42Z","timestamp":1793080902000},"source":"Crossref","is-referenced-by-count":0,"title":["Cardiovascular and metabolic acute effects of heated tobacco products in healthy smokers"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-9234-3041","authenticated-orcid":false,"given":"Lea","family":"Strohm","sequence":"first","affiliation":[{"name":"Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz , Langenbeckstr. 1, Mainz 55131 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominika","family":"Mihalikov\u00e1","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz , Langenbeckstr. 1, Mainz 55131 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Czarnowski","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz , Langenbeckstr. 1, Mainz 55131 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Dittmann","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz , Langenbeckstr. 1, Mainz 55131 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominik","family":"Gillenkirch","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz , Langenbeckstr. 1, Mainz 55131 ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7823-7671","authenticated-orcid":false,"given":"Omar","family":"Hahad","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz , Langenbeckstr. 1, Mainz 55131 ,","place":["Germany"]},{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main , Mainz ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Molitor","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz , Langenbeckstr. 1, Mainz 55131 ,","place":["Germany"]},{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main , Mainz ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2435-851X","authenticated-orcid":false,"given":"Marin","family":"Kuntic","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz , Langenbeckstr. 1, Mainz 55131 ,","place":["Germany"]},{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main , Mainz ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Lurz","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz , Langenbeckstr. 1, Mainz 55131 ,","place":["Germany"]},{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main , Mainz ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"M\u00fcnzel","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz , Langenbeckstr. 1, Mainz 55131 ,","place":["Germany"]},{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main , Mainz ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2769-0094","authenticated-orcid":false,"given":"Andreas","family":"Daiber","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz , Langenbeckstr. 1, Mainz 55131 ,","place":["Germany"]},{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main , Mainz ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Stamm","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz , Langenbeckstr. 1, Mainz 55131 ,","place":["Germany"]},{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main , Mainz ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,10,27]]},"reference":[{"key":"2026102702013549700_zwag524-B1","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1136\/tobaccocontrol-2018-054419","article-title":"Heat-not-burn tobacco products: a systematic literature review","volume":"28","author":"Simonavicius","year":"2019","journal-title":"Tob Control"},{"key":"2026102702013549700_zwag524-B2","doi-asserted-by":"crossref","first-page":"1050","DOI":"10.1001\/jamainternmed.2017.1419","article-title":"Heat-not-burn tobacco cigarettes: smoke by any other name","volume":"177","author":"Auer","year":"2017","journal-title":"JAMA Intern Med"},{"key":"2026102702013549700_zwag524-B3","first-page":"1764","article-title":"Nicotine and the cardiovascular system: unmasking a global public health threat","volume":"47","author":"M\u00fcnzel","year":"2025","journal-title":"Eur Heart J"},{"key":"2026102702013549700_zwag524-B4","author":"International"},{"key":"2026102702013549700_zwag524-B5","doi-asserted-by":"crossref","first-page":"1430","DOI":"10.1111\/add.16199","article-title":"Global prevalence of heated tobacco product use, 2015-22: a systematic review and meta-analysis","volume":"118","author":"Sun","year":"2023","journal-title":"Addiction"},{"key":"2026102702013549700_zwag524-B6","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2024-094610","article-title":"Heated tobacco product use prevalence and temporal trends among the German population: a series of representative cross-sectional household surveys, 2018-2023","volume":"15","author":"Keller","year":"2025","journal-title":"BMJ Open"},{"key":"2026102702013549700_zwag524-B7","doi-asserted-by":"crossref","first-page":"100159","DOI":"10.1016\/j.lanepe.2021.100159","article-title":"Prevalence and reasons for use of heated tobacco products (HTP) in Europe: an analysis of eurobarometer data in 28 countries","volume":"8","author":"Laverty","year":"2021","journal-title":"Lancet Reg Health Eur"},{"key":"2026102702013549700_zwag524-B8","doi-asserted-by":"crossref","DOI":"10.18332\/tid\/200072","article-title":"Global, regional, and national cardiovascular disease burden attributable to smoking from 1990 to 2021: findings from the GBD 2021 study","volume":"23","author":"Zhu","year":"2025","journal-title":"Tob Induc Dis"},{"key":"2026102702013549700_zwag524-B9","doi-asserted-by":"crossref","first-page":"H2","DOI":"10.1152\/ajpheart.00471.2010","article-title":"Assessment of flow-mediated dilation in humans: a methodological and physiological guideline","volume":"300","author":"Thijssen","year":"2011","journal-title":"Am J Physiol Heart Circ Physiol"},{"key":"2026102702013549700_zwag524-B10","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.115.002270","article-title":"Prognostic value of flow-mediated vasodilation in brachial artery and fingertip artery for cardiovascular events: a systematic review and meta-analysis","volume":"4","author":"Matsuzawa","year":"2015","journal-title":"J Am Heart Assoc"},{"key":"2026102702013549700_zwag524-B11","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1161\/01.CIR.94.1.6","article-title":"Antioxidant vitamin C improves endothelial dysfunction in chronic smokers","volume":"94","author":"Heitzer","year":"1996","journal-title":"Circulation"},{"key":"2026102702013549700_zwag524-B12","doi-asserted-by":"crossref","first-page":"2673","DOI":"10.1161\/hc4601.099485","article-title":"Endothelial dysfunction, oxidative stress, and risk of cardiovascular events in patients with coronary artery disease","volume":"104","author":"Heitzer","year":"2001","journal-title":"Circulation"},{"key":"2026102702013549700_zwag524-B13","doi-asserted-by":"crossref","first-page":"E36","DOI":"10.1161\/01.RES.86.2.e36","article-title":"Tetrahydrobiopterin improves endothelium-dependent vasodilation in chronic smokers: evidence for a dysfunctional nitric oxide synthase","volume":"86","author":"Heitzer","year":"2000","journal-title":"Circ Res"},{"key":"2026102702013549700_zwag524-B14","article-title":"Noise, air, and heavy metal pollution as risk factors for endothelial dysfunction","volume":"18","author":"Bayo Jimenez","year":"2023","journal-title":"Eur Cardiol"},{"key":"2026102702013549700_zwag524-B15","doi-asserted-by":"crossref","first-page":"s13","DOI":"10.1136\/tobaccocontrol-2018-054325","article-title":"Vascular endothelial function is impaired by aerosol from a single IQOS HeatStick to the same extent as by cigarette smoke","volume":"27","author":"Nabavizadeh","year":"2018","journal-title":"Tob Control"},{"key":"2026102702013549700_zwag524-B16","doi-asserted-by":"crossref","first-page":"1324","DOI":"10.1161\/ATVBAHA.122.318051","article-title":"Impairment of endothelial function by cigarette smoke is not caused by a specific smoke constituent, but by vagal input from the airway","volume":"42","author":"Nabavizadeh","year":"2022","journal-title":"Arterioscler Thromb Vasc Biol"},{"key":"2026102702013549700_zwag524-B17","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.118.010455","article-title":"Acute effects of heat-not-burn, electronic vaping, and traditional tobacco combustion cigarettes: the sapienza university of Rome-vascular assessment of proatherosclerotic effects of smoking (SUR - VAPES) 2 randomized trial","volume":"8","author":"Biondi-Zoccai","year":"2019","journal-title":"J Am Heart Assoc"},{"key":"2026102702013549700_zwag524-B18","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1136\/thoraxjnl-2020-215900","article-title":"Impact of chronic use of heat-not-burn cigarettes on oxidative stress, endothelial dysfunction and platelet activation: the SUR-VAPES chronic study","volume":"76","author":"Loffredo","year":"2021","journal-title":"Thorax"},{"key":"2026102702013549700_zwag524-B19","doi-asserted-by":"crossref","first-page":"117335","DOI":"10.1016\/j.atherosclerosis.2023.117335","article-title":"Use of heated tobacco products (IQOS) causes an acute increase in arterial stiffness and platelet thrombus formation","volume":"390","author":"Lyytinen","year":"2024","journal-title":"Atherosclerosis"},{"key":"2026102702013549700_zwag524-B20","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s12012-024-09934-6","article-title":"Vascular stress markers following inhalation of heated tobacco products: a study on extracellular vesicles","volume":"25","author":"Antoniewicz","year":"2025","journal-title":"Cardiovasc Toxicol"},{"key":"2026102702013549700_zwag524-B21","doi-asserted-by":"crossref","first-page":"H1234","DOI":"10.1152\/ajpheart.00708.2020","article-title":"Heat-not-burn tobacco products: an emerging threat to cardiovascular health","volume":"319","author":"Fried","year":"2020","journal-title":"Am J Physiol Heart Circ Physiol"},{"key":"2026102702013549700_zwag524-B22","doi-asserted-by":"crossref","first-page":"108409","DOI":"10.1016\/j.mrrev.2021.108409","article-title":"DNA damage, DNA repair and carcinogenicity: tobacco smoke versus electronic cigarette aerosol","volume":"789","author":"Tang","year":"2022","journal-title":"Mutat Res Rev Mutat Res"},{"key":"2026102702013549700_zwag524-B23","doi-asserted-by":"crossref","first-page":"1111","DOI":"10.1016\/0140-6736(92)93147-F","article-title":"Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis","volume":"340","author":"Celermajer","year":"1992","journal-title":"Lancet"},{"key":"2026102702013549700_zwag524-B24","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1093\/eurheartj\/ehq412","article-title":"Flow-mediated constriction: further insight into a new measure of vascular function","volume":"32","author":"Gori","year":"2011","journal-title":"Eur Heart J"},{"key":"2026102702013549700_zwag524-B25","doi-asserted-by":"crossref","first-page":"2265","DOI":"10.3390\/nu16142265","article-title":"Effects of short-term gluten-free diet on cardiovascular biomarkers and quality of life in healthy individuals: a prospective interventional study","volume":"16","author":"Lange","year":"2024","journal-title":"Nutrients"},{"key":"2026102702013549700_zwag524-B26","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1016\/j.atherosclerosis.2008.11.032","article-title":"Flow-mediated dilation in patients with coronary artery disease is enhanced by high dose atorvastatin compared to combined low dose atorvastatin and ezetimibe: results of the CEZAR study","volume":"205","author":"Ostad","year":"2009","journal-title":"Atherosclerosis"},{"key":"2026102702013549700_zwag524-B27","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1007\/s00395-016-0571-4","article-title":"Nitroglycerin induces DNA damage and vascular cell death in the setting of nitrate tolerance","volume":"111","author":"Mikhed","year":"2016","journal-title":"Basic Res Cardiol"},{"key":"2026102702013549700_zwag524-B28","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1016\/j.redox.2013.12.020","article-title":"OpenComet: an automated tool for comet assay image analysis","volume":"2","author":"Gyori","year":"2014","journal-title":"Redox Biol"},{"key":"2026102702013549700_zwag524-B29","doi-asserted-by":"crossref","first-page":"674622","DOI":"10.3389\/fcvm.2021.674622","article-title":"Cigarette smoking is related to endothelial dysfunction of resistance, but not conduit arteries in the general population-results from the gutenberg health study","volume":"8","author":"Hahad","year":"2021","journal-title":"Front Cardiovasc Med"},{"key":"2026102702013549700_zwag524-B30","doi-asserted-by":"crossref","first-page":"4057","DOI":"10.1093\/eurheartj\/ehaa460","article-title":"Effects of tobacco cigarettes, e-cigarettes, and waterpipe smoking on endothelial function and clinical outcomes","volume":"41","author":"M\u00fcnzel","year":"2020","journal-title":"Eur Heart J"},{"key":"2026102702013549700_zwag524-B31","doi-asserted-by":"crossref","first-page":"2472","DOI":"10.1093\/eurheartj\/ehz772","article-title":"Short-term e-cigarette vapour exposure causes vascular oxidative stress and dysfunction: evidence for a close connection to brain damage and a key role of the phagocytic NADPH oxidase (NOX-2)","volume":"41","author":"Kuntic","year":"2020","journal-title":"Eur Heart J"},{"key":"2026102702013549700_zwag524-B32","author":"World Health Organization"},{"key":"2026102702013549700_zwag524-B33","doi-asserted-by":"crossref","first-page":"5406","DOI":"10.1111\/jcmm.13812","article-title":"Nicotine induces endothelial dysfunction and promotes atherosclerosis via GTPCH1","volume":"22","author":"Li","year":"2018","journal-title":"J Cell Mol Med"},{"key":"2026102702013549700_zwag524-B34","doi-asserted-by":"crossref","first-page":"3227","DOI":"10.1093\/eurheartj\/ehab484","article-title":"2021 ESC guidelines on cardiovascular disease prevention in clinical practice","volume":"42","author":"Visseren","year":"2021","journal-title":"Eur Heart J"},{"key":"2026102702013549700_zwag524-B35","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1161\/CIR.0000000000001293","article-title":"Impact of smokeless oral nicotine products on cardiovascular disease: implications for policy, prevention, and treatment: a policy statement from the American Heart Association","volume":"151","author":"Dennison Himmelfarb","year":"2025","journal-title":"Circulation"},{"key":"2026102702013549700_zwag524-B36","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1161\/CIR.0000000000001160","article-title":"Cardiopulmonary impact of electronic cigarettes and vaping products: a scientific statement from the American Heart Association","volume":"148","author":"Rose","year":"2023","journal-title":"Circulation"},{"key":"2026102702013549700_zwag524-B37","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1016\/j.tcm.2016.03.001","article-title":"Cardiovascular toxicity of nicotine: implications for electronic cigarette use","volume":"26","author":"Benowitz","year":"2016","journal-title":"Trends Cardiovasc Med"},{"key":"2026102702013549700_zwag524-B38","doi-asserted-by":"crossref","first-page":"2947","DOI":"10.3390\/ijerph17082947","article-title":"Impact of electronic alternatives to tobacco cigarettes on indoor air particular matter levels","volume":"17","author":"Protano","year":"2020","journal-title":"Int J Environ Res Public Health"},{"key":"2026102702013549700_zwag524-B39","doi-asserted-by":"crossref","first-page":"680","DOI":"10.3389\/fendo.2018.00680","article-title":"Particulate matter air pollution: effects on the cardiovascular system","volume":"9","author":"Hamanaka","year":"2018","journal-title":"Front Endocrinol (Lausanne)"},{"key":"2026102702013549700_zwag524-B40","doi-asserted-by":"crossref","first-page":"00595-2022","DOI":"10.1183\/23120541.00595-2022","article-title":"Acute health effects of heated tobacco products: comparative analysis with traditional cigarettes and electronic cigarettes in young adults","volume":"9","author":"Majek","year":"2023","journal-title":"ERJ Open Res"},{"key":"2026102702013549700_zwag524-B41","doi-asserted-by":"crossref","first-page":"H144","DOI":"10.1152\/ajpheart.00628.2020","article-title":"Acute e-cig inhalation impacts vascular health: a study in smoking na\u00efve subjects","volume":"320","author":"Chatterjee","year":"2021","journal-title":"Am J Physiol Heart Circ Physiol"},{"key":"2026102702013549700_zwag524-B42","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/j.bbrc.2022.04.042","article-title":"Increased oxidative stress and effects on inflammatory cytokine secretion by heated tobacco products aerosol exposure to mice","volume":"610","author":"Sawa","year":"2022","journal-title":"Biochem Biophys Res Commun"},{"key":"2026102702013549700_zwag524-B43","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1007\/s00592-022-02009-4","article-title":"Heated tobacco product use and abnormal glucose metabolism: a working population-based study","volume":"60","author":"Hu","year":"2023","journal-title":"Acta Diabetol"},{"key":"2026102702013549700_zwag524-B44","doi-asserted-by":"crossref","first-page":"1554","DOI":"10.1152\/jappl.1996.80.5.1554","article-title":"Smoking increases conversion of lactate to glucose during submaximal exercise","volume":"80","author":"Huie","year":"1996","journal-title":"J Appl Physiol (1985)"},{"key":"2026102702013549700_zwag524-B45","doi-asserted-by":"crossref","first-page":"1289","DOI":"10.1021\/acs.chemrestox.9b00085","article-title":"Comparison of free radical levels in the aerosol from conventional cigarettes, electronic cigarettes, and heat-not-burn tobacco products","volume":"32","author":"Shein","year":"2019","journal-title":"Chem Res Toxicol"},{"key":"2026102702013549700_zwag524-B46","doi-asserted-by":"crossref","first-page":"1882","DOI":"10.1021\/acs.chemrestox.0c00088","article-title":"Free radical production and characterization of heat-not-burn cigarettes in comparison to conventional and electronic cigarettes","volume":"33","author":"Bitzer","year":"2020","journal-title":"Chem Res Toxicol"},{"key":"2026102702013549700_zwag524-B47","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1080\/10715762.2025.2521633","article-title":"Heated tobacco product emissions induce DNA damage in human bronchial epithelial cells via radical formation","volume":"59","author":"Davigo","year":"2025","journal-title":"Free Radic Res"},{"key":"2026102702013549700_zwag524-B48","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.toxlet.2011.09.029","article-title":"Analysis of nicotine-induced DNA damage in cells of the human respiratory tract","volume":"208","author":"Ginzkey","year":"2012","journal-title":"Toxicol Lett"},{"key":"2026102702013549700_zwag524-B49","doi-asserted-by":"crossref","first-page":"2200951","DOI":"10.1183\/13993003.00951-2022","article-title":"Nicotine promotes e-cigarette vapour-induced lung inflammation and structural alterations","volume":"61","author":"Roxlau","year":"2023","journal-title":"Eur Respir J"}],"container-title":["European Journal of Preventive Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/eurjpc\/advance-article-pdf\/doi\/10.1093\/eurjpc\/zwag524\/72524640\/zwag524.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eurjpc\/advance-article-pdf\/doi\/10.1093\/eurjpc\/zwag524\/72524640\/zwag524.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T06:01:50Z","timestamp":1793080910000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eurjpc\/advance-article\/doi\/10.1093\/eurjpc\/zwag524\/9002310"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,27]]},"references-count":49,"URL":"https:\/\/doi.org\/10.1093\/eurjpc\/zwag524","relation":{},"ISSN":["2047-4873","2047-4881"],"issn-type":[{"value":"2047-4873","type":"print"},{"value":"2047-4881","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,27]]},"article-number":"zwag524"}}